Irrational use of antimicrobials is a serious issue worldwide, especially in China. To deal with the situation, several national policies have been issued by the Ministry of Health, including the Essential Medicines List policy and the Zero Mark-up policy.1

However, there are no operational details on how to implement the policy, and no guidelines on the diagnosis and treatment of childhood URIs or any related necessary clinician training, especially for primary care doctors. In 2009, China launched the Essential Medicines List policy, which was supported by the centralised procurement of essential medicines and the Zero Mark-up policy. However, there was no significant improvement in the rational use of medicines and cost control so far.1

Key policy implications

Provider-targeted and regular peer education on how to diagnose and treat URI correctly is important to improve prescribing practice.

Additional interventions need to be developed to tackle over-prescribing of antivirals and glucocorticoids.

To reduce antibiotic prescription for childhood URIs, the most effective interventions involve clinicians and parents.

Interventions that targeted both clinicians and parents for up to 3 months’ duration, particularly training on doctor–patient communication skills, showed better effects than individual interventions;3

APR feedback and updated guidelines were effective in reducing APR for childhood URIs.3

Policy implications:

Further training for clinicians is required on clinical skills and their communication with patients.

Improved communication between clinicians and parents is an essential part of antibiotic stewardship for childhood URIs.

Findings on the antibiotics prescription rate and other medicine prescriptions